A boy watches while an MSF nurse cleans his infected wound at a displaced persons' camp in Juba.

January 30, 2014

By Arjan Hehenkamp, MSF General Director

When I left South Sudan ten years ago, having worked here for four, I left feeling hopeful. A ceasefire had been signed (between Sudan and opposition forces in the south) and a peace-agreement was under discussion. A few years later South Sudan became an independent country, a master of its destiny.

I was not so naïve to expect that this would come without difficult moments, but the scale, speed and impact of the violence which erupted in December has shocked me. It was too much to hear about through South Sudanese friends from afar, and so I came back to South Sudan, ten days ago, now as General Director of Médecins Sans Frontières/Doctors Without Borders (MSF), to help oversee our emergency operations.

In the past ten days I have heard harrowing stories of violence on my visits to MSF’s operations. In Nimule, a young boy called Deng approached me asking for help after losing his entire family in Bor. I have witnessed the impact of hundreds of thousands of people being forced from their homes, making long journeys with little food, water, access to shelter or medical care. At our clinic in Lankien, I met Marion, who had fled violence in Bor whilst heavily pregnant, making a long arduous journey to our clinic just in time to give birth to a healthy baby girl. And I have seen people enclosed in camps by their own fear, living under impossible conditions and scared to venture outside and uncertain of the future.

I have seen MSF’s hospitals and clinics overwhelmed; in Lankien, Jonglei State, our patient numbers have quadrupled and the local population has tripled in size due to the influx of the displaced. And sadly I have seen MSF’s life-saving medical services stop running when they are needed most, due to violence, looting, and destruction.

Ordinary citizens of South Sudan have been extraordinarily affected by the violent events of the past weeks. The destruction of hospitals and markets, as well as the increased pressure on host communities due to mass displacement, brings me to this conclusion: South Sudan will face a humanitarian emergency for the months to come, and its people will need all the help they can get.

MSF has been working in the area that is now South Sudan for more than 30 years. Our emergency teams are already deployed in Juba, Awerial, Lankien, Nasir, and Nimule, while teams have just returned to Malakal and Bentiu on Monday. Teams are preparing to go to Bor. Our priorities will be set by the needs of the people, but I am sure we will have to maintain a wide range of activities from medical, to nutrition, to water and sanitation as well as surgery.

For MSF to save lives, three conditions are critical. First, MSF needs to be able to treat everyone who is in acute need, irrespective of who is in control, the government or the opposition. Second, and closely associated to this, MSF needs to be in dialogue with all parties to the conflict—being fully transparent on all our activities and intentions—to retain trusting and open relationships in which common solutions and problems can be addressed.

And, finally and most importantly, we need the commitment of all parties to the conflict, from the top commander to the common soldier, of their absolute resolve to respect, rather than attack, patients, health facilities and the MSF teams.

Having met government officials in Juba and Nimule, and local authorities in opposition-controlled areas, I am impressed with their dedication to support our work. I am mindful, however, that the realities on the ground can be more difficult to influence—something MSF teams have painfully experienced in Malakal, Bentiu and elsewhere.

So the next steps are clear: MSF will, in contact with all relevant authorities, bring in the necessary teams and resources to face this emergency, using our own logistical capacity to ensure our independence. In return, we will continue to insist that these same authorities honour their own commitment to support our work. So that, in the end, a maximum effort can be made to address the needs of Marion, Deng, and the other hundreds of thousands of people who deserve and need our solidarity and support.